EP0481527B1 - Set of instruments for the transvaginal gamete transfer and for catheterization - Google Patents

Set of instruments for the transvaginal gamete transfer and for catheterization Download PDF

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Publication number
EP0481527B1
EP0481527B1 EP91118952A EP91118952A EP0481527B1 EP 0481527 B1 EP0481527 B1 EP 0481527B1 EP 91118952 A EP91118952 A EP 91118952A EP 91118952 A EP91118952 A EP 91118952A EP 0481527 B1 EP0481527 B1 EP 0481527B1
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EP
European Patent Office
Prior art keywords
guide tube
catheter
catheter guide
distal end
tube
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EP91118952A
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German (de)
French (fr)
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EP0481527A1 (en
Inventor
Otto Schinkel
Josef Norvath
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Labotect-Labor-Technik Gottingen GmbH
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Labotect-Labor-Technik Gottingen GmbH
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/32—Devices for opening or enlarging the visual field, e.g. of a tube of the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/42—Gynaecological or obstetrical instruments or methods

Definitions

  • the invention relates to an instrument set for transvaginal gamete transfer and for tube catheterization with a catheter guide tube and a catheter, the catheter guide tube being flexible in its distal end region and having a curvature there with respect to its axis.
  • An instrument set of the type described in the introduction is known from FR-A-26 35 453, which was only published after the effective filing date and is therefore not part of the prior art under Article 54 (2) EPC.
  • Catheter guide tube made in one piece from plastic and tapering at its distal end.
  • a stylet is provided that extends the catheter guide tube. The curvature disappears in its distal end region. The distal end area of the catheter has a reduced diameter.
  • a stylet is provided for the catheter guide tube, which has the same curvature as the catheter guide tube.
  • the catheter guide tube is again made in one piece from plastic and the catheter is reduced in diameter in its distal end region.
  • the catheter guide tube tapers towards its distal end. At its distal end itself, however, it has a rounded surface.
  • a movable marking is provided on the catheter guide tube as an orientation mark.
  • the catheter has a fixed marking on its outside, which indicates when the distal end of the catheter comes out of the catheter guide tube.
  • the use of a stylet is also provided for inserting this catheter guide tube into the uterus. It is therefore also largely unyielding at this stage.
  • a surgical instrument set for transurethral surgery is known from DE-A-27 27 273.
  • This set of instruments has a guide tube and an obturator.
  • the guide tube is designed to be flexible and has a curvature in relation to its axis in its distal end region.
  • the obturator is spherical at its distal end, the diameter of the ball being matched to the inside diameter of the guide tube in such a way that the obturator can be pushed through the guide tube.
  • the distal end region of the obturator 6 can be formed by a band wound helically around a bendable core.
  • An instrument set for transvaginal interventions is known from US-A-33 20 948.
  • This set of instruments includes a hollow needle and a guide tube.
  • the guide tube has a distal end with an enlarged diameter.
  • the invention has for its object to develop an instrument set of the type described in the introduction such that it is suitable for the injury-free insertion of the catheter guide tube.
  • the catheter guide tube is spherical at its distal end and in that the catheter guide tube consists of a spirally wound band construction in its distal end region. At least in its distal end area, the catheter guide tube is spirally wound. It has enormous flexibility there and adapts particularly easily to the curvatures of the uterus. This eliminates furrows and injuries to the endometrium. The spherical distal end of the catheter guide tube also contributes to this.
  • the spirally wound area can be extended to about half the total length of the catheter guide tube.
  • the catheter guide tube can have a radially offset wing, which is arranged on the circumference of the catheter guide tube in accordance with the curvature. This makes it possible for the doctor to follow the front curvature of the catheter guide tube at its proximal end and to read its position, so that a targeted rotation of the distal end of the catheter guide tube is also possible.
  • the outside of the catheter guide tube can have a scale as an orientation aid, which cooperates, for example, with a clamp holder of a speculum.
  • the outside of the catheter can have a scale that cooperates with the proximal end of the catheter guide tube. This shows how far the front end of the catheter protrudes from the front end of the catheter guide tube.
  • the distal end region of the catheter can have a reduced diameter. In this way it is possible to reach the isthmic tube section with little resistance through the catheter.
  • the catheter protrudes from the catheter guide tube and is used without the guide tube.
  • FIG. 1 schematically and partially shows a uterus 1 with a portio 2, endometrium 3 and a tube 4.
  • a speculum 5 is inserted into a vagina 6.
  • the speculum 5 has an upper spoon 7 and a lower spoon 8.
  • the lower spoon 8 is pivotally mounted on the upper spoon 7 via a joint 9.
  • a spreader 10 is provided on the speculum 5, with the aid of which 11 upper spoons 7 and lower spoons 8 can be spread apart or brought together by relative rotation of a nut.
  • the speculum 5 is shown in FIG. 1 in the desired spread position. It is inserted into the vagina 6 in the non-spread state, rotated through 90 ° and then spread with the spreading device 15.
  • the upper spoon 7 and the lower spoon 8 have recesses 12 which are designed to be closed at the edge and have the shape of slot-like slots.
  • the wall of the sheath 6 partially lies into the recesses 16 and 17, as a result of which the speculum is held in a firm, non-slip position.
  • the upper spoon 7 has an open edge 18 on its rear part, as a result of which the doctor's area of view of the portio 2 is significantly improved.
  • An abutment 14 for ball pliers 15 is formed on the speculum 5.
  • the ball tong 15 has two articulated arms 16 and 17, at the front ends of which inward bends 18 and 19 are provided. With the bends 18 and 19, the portio 2 can be gripped in order to bring the uterus 1 into a largely extended position by pulling on the spherical forceps 15. In this position, the ball tongs 15 are suspended with the aid of a bolt 20 in a slot 21 of the abutment 14.
  • a catheter 22 with a catheter guide tube 23 is used for the actual transvaginal gamete transfer and for tube catheterization.
  • the catheter guide tube 23 has a pre-shaped curvature 24 in its distal end region.
  • the catheter guide tube 23 is spherical at its distal end.
  • the ball 25 facilitates the easy insertion of the catheter guide tube into the entrance area of the tube 4.
  • the catheter guide tube 23 is hollow and allows the catheter 22 to be pushed through.
  • the catheter guide tube 23 is designed to be very flexible and consists of a wound band construction that enables this extensive flexibility.
  • the catheter guide tube has an insertion cone 26 for the catheter 22.
  • a radially offset wing 27 is also provided in the proximal end region and is arranged in such a way that it coincides with the curvature 24 in the distal end region of the catheter guide tube 23.
  • a clamping bracket 28 is provided on the spherical forceps 15 and can be clamped into the catheter guide tube 23. In this way, the seat of the catheter guide tube 23 can be fixed after insertion. The catheter guide tube 23 has reached its proper seat when the ball 25 is at the entrance to the tube 4. Ultimately, the catheter guide tube 23 is mounted on the speculum 5 via the ball forceps 15. On the outside of the catheter guide tube 23 there is a scale 29 which cooperates with the clamping bracket 28 and serves for orientation.
  • the catheter 22 essentially consists of a thin plastic tube 30 and is very flexible. On the outside of the plastic tube 30 there is a scale 31 which cooperates with the proximal end of the catheter guide tube 23, that is to say the insertion cone 26.
  • the plastic tube 30 has a distal end part 32, which has a reduced diameter compared to the remaining part of the plastic tube 30. It is the part of the catheter 22 which is pushed over the distal end of the catheter guide tube 23 in order to pass through the isthmic tube section.
  • the distal end 33 of the catheter 22 is rounded.
  • a connector 34 for a syringe is provided at the proximal end of the catheter 22.
  • the instrument set consisting of catheter 22 and catheter guide tube 23 is used as follows: First, the catheter guide tube 23 is inserted through the endometrium 3 to the entrance of the tube 4. The catheter guide tube 23 can be pushed delicately during insertion. By rotating the catheter guide tube 23, the curvature 24 can so be relocated so that the insertion takes place against the lowest possible resistance and without any injuries.
  • the wing 27 shows the doctor to which side the curvature 24 is directed. Once the catheter guide tube 23 has reached its proper seat, it is clamped into the clamp holder 38, and the doctor can use the scale 40 to remember the correct position and thus the insertion depth of the catheter guide tube 23. This is useful for a second or multiple use of the instrument set with the same patient.
  • the distal end 44 of the catheter 22 is inserted into the insertion cone 26 of the catheter guide tube 23 and first pushed through until the distal end 33 of the catheter 22 is on the ball 25.
  • This is indicated to the doctor by the start of the scale 31, the first line of which is then on the insertion cone 26.
  • Each further line on the scale 31 indicates to the doctor that the distal end 33 or the end part 32 has exited the catheter guide tube 23, for example by a further centimeter, and projects beyond the ball 25.
  • the catheter 22 is shifted gently until the end part 32 passes through the isthmic tube section.
  • the doctor can now use the scale 31 to note or note this position, which is specific to the patient concerned.
  • the transvaginal gamete transfer can then take place.

Description

Die Erfindung bezieht sich auf einen Instrumentensatz für den transvaginalen Gametentransfer und für die Tubenkatheterisierung mit einem Katheterführungsrohr und einem Katheter, wobei das Katheterführungsrohr in seinem distalen Endbereich flexibel ausgebildet ist und dort eine Krümmung gegenüber seiner Achse aufweist.The invention relates to an instrument set for transvaginal gamete transfer and for tube catheterization with a catheter guide tube and a catheter, the catheter guide tube being flexible in its distal end region and having a curvature there with respect to its axis.

Bei dem transvaginalen Gametentransfer als auch der Tubenkatheterisierung gilt es, einen Katheter durch die Scheide und den Uterus bis in die entsprechende Tube hinein einzuführen. Da die Katheter, die zum Einführen in die Tube geeignet sind, äußerst flexibel, nachgiebig und mit geringem Durchmesser ausgebildet sein müssen, bedient man sich zu ihrem Einführen bis in den Eingangsbereich der Tube eines KatheterführungsrohrsWith transvaginal gamete transfer and tube catheterization, it is important to insert a catheter through the vagina and uterus into the corresponding tube. Since the catheters that are suitable for insertion into the tube must be designed to be extremely flexible, resilient and of small diameter, a catheter guide tube is used to insert them into the entrance area of the tube

Ein Instrumentensatz der eingangs beschriebenen Art ist aus der FR-A-26 35 453 bekannt, die erst nach dem effektiven Anmeldedatum veröffentlicht wurde und damit gemäß Artikel 54(2) EPÜ nicht zum Stand der Technik zählt. Hierbei ist das Katheterführungsrohr einstückig aus Kunststoff und an seinem distalen Ende spitz zulaufend ausgebildet. Zur Einführung des Katheterführungsrohrs bis in den Uterus hinein ist ein Mandrin vorgesehen, der das Katheterführungsrohr streckt. Hierbei verschwindet die Krümmung in dessen distalem Endbereich. Der distale Endbereich des Katheters ist im Durchmesser reduziert ausgebildet.An instrument set of the type described in the introduction is known from FR-A-26 35 453, which was only published after the effective filing date and is therefore not part of the prior art under Article 54 (2) EPC. Here is that Catheter guide tube made in one piece from plastic and tapering at its distal end. To insert the catheter guide tube into the uterus, a stylet is provided that extends the catheter guide tube. The curvature disappears in its distal end region. The distal end area of the catheter has a reduced diameter.

Bei einem weiteren Instrumentensatz der eingangs beschriebenen Art ist für das Katheterführungsrohr ein Mandrin vorgesehen, der dieselbe Krümmung wie das Katheterführungsrohr aufweist. Das Katheterführungsrohr ist wiederum einstückig aus Kunststoff und der Katheter in seinem distalen Endbereich im Durchmesser reduziert ausgebildet. Auf sein distales Ende zu verjüngt sich das Katheterführungsrohr. An seinem distalen Ende selbst weist es jedoch eine abgerundete Oberfläche auf. An dem Katheterführungsrohr ist eine verschiebbare Markierung als Orientierungsmarke vorgesehen. Der Katheter weist eine feste Markierung auf seiner Außenseite auf, die angibt, wann das distale Ende des Katheters aus dem Katheterführungsrohr heraustritt. Auch zum Einführen dieses Katheterführungsrohrs in den Uterus ist die Verwendung eines Mandrins vorgesehen. Es ist daher in diesem Stadium ebenfalls weitgehend unnachgiebig.In a further set of instruments of the type described in the introduction, a stylet is provided for the catheter guide tube, which has the same curvature as the catheter guide tube. The catheter guide tube is again made in one piece from plastic and the catheter is reduced in diameter in its distal end region. The catheter guide tube tapers towards its distal end. At its distal end itself, however, it has a rounded surface. A movable marking is provided on the catheter guide tube as an orientation mark. The catheter has a fixed marking on its outside, which indicates when the distal end of the catheter comes out of the catheter guide tube. The use of a stylet is also provided for inserting this catheter guide tube into the uterus. It is therefore also largely unyielding at this stage.

Aus der DE-A-27 27 273 ist ein chirurgischer Instrumentensatz für transurethrale Eingriffe bekannt. Dieser Instrumentensatz weist ein Führungsrohr und einen Obturator auf. Das Führungsrohr ist biegsam ausgebildet und weist in seinem distalen Endbereich eine Krümmung gegenüber seiner Achse auf. Der Obturator ist an seinem distalen Ende kugelförmig ausgebildet, wobei der Durchmesser der Kugel derart auf den Innendurchmesser des Führungsrohrs abgestimmt ist, daß der Obturator durch das Führungsrohr hindurchschiebbar ist. Der distale Endbereich des Obturators 6 kann von einem wendelförmig um einen biegbaren Kern gewickelten Band gebildet sein.A surgical instrument set for transurethral surgery is known from DE-A-27 27 273. This set of instruments has a guide tube and an obturator. The guide tube is designed to be flexible and has a curvature in relation to its axis in its distal end region. The obturator is spherical at its distal end, the diameter of the ball being matched to the inside diameter of the guide tube in such a way that the obturator can be pushed through the guide tube. The distal end region of the obturator 6 can be formed by a band wound helically around a bendable core.

Aus der US-A-33 20 948 ist ein Instrumentensatz für transvaginale Eingriffe bekannt. Dieser Instrumentensatz umfaßt eine Hohlnadel und ein Führungsrohr. Das Führungsrohr weist ein distales Ende mit einem vergrößerten Durchmesser auf.An instrument set for transvaginal interventions is known from US-A-33 20 948. This set of instruments includes a hollow needle and a guide tube. The guide tube has a distal end with an enlarged diameter.

Aus der US-A-46 34 432 ist es bekannt, ein Katheterführungsrohr für die intravenöse Verwendung mit einer in die Wandung des Katheterführungsrohrs eingebetteten spiralförmig gewickelten Feder zu verstärken. Damit soll die Flexibilität des Katheterführungsrohrs nicht beeinträchtigt werden.From US-A-46 34 432 it is known to reinforce a catheter guide tube for intravenous use with a helically wound spring embedded in the wall of the catheter guide tube. This should not affect the flexibility of the catheter guide tube.

Der Erfindung liegt die Aufgabe zugrunde, einen Instrumentensatz der eingangs beschriebenen Art derart weiterzubilden, daß er zur verletzungsfreien Einlage des Katheterführungsrohrs geeignet ist.The invention has for its object to develop an instrument set of the type described in the introduction such that it is suitable for the injury-free insertion of the catheter guide tube.

Erfindungsgemäß wird dies dadurch erreicht, daß das Katheterführungsrohr an seinem distalen Ende kugelförmig ausgebildet ist und daß das Katheterführungsrohr in seinem distalen Endbereich aus einer spiralförmig gewickelten Bandkonstruktion besteht. Zumindest in seinem distalen Endbereich ist das Katheterführungsrohr spiralförmig gewickelt ausgebildet. So weist es dort eine enorme Flexibilität auf, und paßt sich den Krümmungen des Uterus besonders leicht an. Damit sind Furchungen und Verletzungen des Endometriums ausgeschlossen. Hierzu trägt auch das kugelförmige distale Ende des Katheterführungsrohrs bei. Der spiralförmig gewickelte Bereich kann etwa bis zur Hälfte der Gesamtlänge des Katheterführungsrohrs ausgedehnt sein.This is achieved according to the invention in that the catheter guide tube is spherical at its distal end and in that the catheter guide tube consists of a spirally wound band construction in its distal end region. At least in its distal end area, the catheter guide tube is spirally wound. It has enormous flexibility there and adapts particularly easily to the curvatures of the uterus. This eliminates furrows and injuries to the endometrium. The spherical distal end of the catheter guide tube also contributes to this. The spirally wound area can be extended to about half the total length of the catheter guide tube.

Das Katheterführungsrohr kann in seinem proximalen Endbereich einen radial abgesetzten Flügel aufweisen, der entsprechend der Krümmung am Umfang des Katheterführungsrohrs angeordnet ist. Damit wird es für den Arzt möglich, die vordere Krümmung des Katheterführungsrohrs an seinem proximalen Ende zu verfolgen und ihre Lage abzulesen, so daß auch eine gezielte Drehung des distalen Endes des Katheterführungsrohrs möglich wird.In its proximal end region, the catheter guide tube can have a radially offset wing, which is arranged on the circumference of the catheter guide tube in accordance with the curvature. This makes it possible for the doctor to follow the front curvature of the catheter guide tube at its proximal end and to read its position, so that a targeted rotation of the distal end of the catheter guide tube is also possible.

Das Katheterführungsrohr kann auf seiner Außenseite eine Skala als Orientierungshilfe aufweisen, die beispielsweise mit einer Klemmhalterung eines Spekulums zusammenarbeitet. Dem Arzt ist dadurch bei Mehrfachanwendung des Instrumentensatzes an ein der derselben Patientin die Möglichkeit gegeben, bei jeder weiteren Anwendung das Katheterführungsrohrs so einzuführen, daß sein vorderes Ende seinen ordnungsgemäßen Sitz erhält und nicht zu tief eingeführt wird.The outside of the catheter guide tube can have a scale as an orientation aid, which cooperates, for example, with a clamp holder of a speculum. When the instrument set is used multiple times on one of the same patient, the doctor is thereby given the opportunity, with each subsequent application, to insert the catheter guide tube in such a way that its front end is properly seated and is not inserted too deeply.

Der Katheter kann auf seiner Außenseite eine mit dem proximalen Ende des Katheterführungsrohrs zusammenarbeitende Skala aufweisen. An dieser ist erkennbar, wieweit das vordere Ende des Katheters gegenüber dem vorderen Ende des Katheterführungsrohrs ausragt.The outside of the catheter can have a scale that cooperates with the proximal end of the catheter guide tube. This shows how far the front end of the catheter protrudes from the front end of the catheter guide tube.

Der distale Endbereich des Katheters kann im Durchmesser reduziert ausgebildet sein. Auf diese Weise ist es möglich, durch den Katheter den isthmischen Tubenabschnitt mit geringem Widerstand zu erreichen. Hierbei ragt der Katheter aus dem Katheterführungsrohr heraus und wird ohne das Führungsrohr angewendet.The distal end region of the catheter can have a reduced diameter. In this way it is possible to reach the isthmic tube section with little resistance through the catheter. The catheter protrudes from the catheter guide tube and is used without the guide tube.

Die Erfindung wird anhand eines bevorzugten Ausführungsbeispiels weiter erläutert und beschrieben. Es zeigen:

Figur 1
eine Darstellung des Instrumentensatzes bei der Anwendung und
Figur 2
die Teile des Instrumentensatzes.
The invention is further explained and described on the basis of a preferred exemplary embodiment. Show it:
Figure 1
a representation of the set of instruments in use and
Figure 2
the parts of the instrument set.

In Figur 1 ist schematisch und teilweise ein Uterus 1 mit Portio 2, Endometrium 3 und einer Tube 4 dargestellt. Ein Spekulum 5 ist in eine Scheide 6 eingeführt. Das Spekulum 5 weist einen Oberlöffel 7 und einen Unterlöffel 8 auf. Der Unterlöffel 8 ist über ein Gelenk 9 schwenkbar an dem Oberlöffel 7 gelagert. An dem Spekulum 5 ist eine Spreizeinrichtung 10 vorgesehen, mit deren Hilfe durch relatives Verdrehen einer Mutter 11 Oberlöffel 7 und Unterlöffel 8 gegeneinander gespreizt bzw. zusammengeführt werden können. Das Spekulum 5 ist in Figur 1 in der gewünschten gespreizten Lage dargestellt. Es wird in ungespreiztem Zustand in die Scheide 6 eingeführt, um 90° gedreht und dann mit der Spreizeinrichtung 15 gespreizt. Der Oberlöffel 7 und der Unterlöffel 8 weisen Aussparungen 12 auf, die randgeschlossen ausgebildet sind und die Form von langlochartigen Schlitzen haben. Beim Spreizen des Spekulums 5 legt sich die Wandung der Scheide 6 teilweise in die Aussparungen 16 und 17 hinein, wodurch das Spekulum seinen festen, unverrutschbaren Sitz erhält. Der Oberlöffel 7 weist an seinem hinteren Teil eine randoffene Ausnehmung 18 auf, wodurch der Einblicksbereich des Arztes auf die Portio 2 wesentlich verbessert wird.FIG. 1 schematically and partially shows a uterus 1 with a portio 2, endometrium 3 and a tube 4. A speculum 5 is inserted into a vagina 6. The speculum 5 has an upper spoon 7 and a lower spoon 8. The lower spoon 8 is pivotally mounted on the upper spoon 7 via a joint 9. A spreader 10 is provided on the speculum 5, with the aid of which 11 upper spoons 7 and lower spoons 8 can be spread apart or brought together by relative rotation of a nut. The speculum 5 is shown in FIG. 1 in the desired spread position. It is inserted into the vagina 6 in the non-spread state, rotated through 90 ° and then spread with the spreading device 15. The upper spoon 7 and the lower spoon 8 have recesses 12 which are designed to be closed at the edge and have the shape of slot-like slots. When the speculum 5 is spread, the wall of the sheath 6 partially lies into the recesses 16 and 17, as a result of which the speculum is held in a firm, non-slip position. The upper spoon 7 has an open edge 18 on its rear part, as a result of which the doctor's area of view of the portio 2 is significantly improved.

An dem Spekulum 5 ist ein Widerlager 14 für eine Kugelzange 15 ausgebildet. Die Kugelzange 15 weist zwei Gelenkarme 16 und 17 auf, an deren vorderen Enden nach innen gerichtete Umbiegungen 18 und 19 vorgesehen sind. Mit den Umbiegungen 18 und 19 kann die Portio 2 ergriffen werden, um den Uterus 1 durch Ziehen an der Kugelzange 15 in eine weitgehend gestreckte Lage zu bringen. In dieser Stellung wird die Kugelzange 15 mit Hilfe eines Bolzens 20 in einen Schlitz 21 des Widerlagers 14 eingehängt. Zum eigentlichen transvaginalen Gametentransfer und zur Tubenkatheterisierung dient ein Katheter 22 mit Katheterführungsrohr 23. Das Katheterführungsrohr 23 weist in seinem distalen Endbereich eine vorgeformte Krümmung 24 auf. An seinem distalen Ende ist das Katheterführungsrohr 23 kugelförmig ausgebildet. Die Kugel 25 erleichtert das leichte Einführen des Katheterführungsrohr bis in den Eingangsbereich der Tube 4. Es versteht sich, daß das Katheterführungsrohr 23 hohl ausgebildet ist und das Hindurchschieben des Katheters 22 ermöglicht. Insbesondere in seinem distalen Endbereich, jedoch auch ausgedehnt bis zur Hälfte seiner Gesamtlänge, ist das Katheterführungsrohr 23 sehr biegsam ausgebildet und besteht aus einer gewickelten Bandkonstruktion, die diese weitgehende Flexibilität ermöglicht. An seinem proximalen Ende weist das Katheterführungsrohr einen Einführkonus 26 für den Katheter 22 auf. In dem proximalen Endbereich ist auch ein radial abgesetzter Flügel 27 vorgesehen, der so angeordnet ist, daß er mit der Krümmung 24 im distalen Endbereich des Katheterführungsrohrs 23 übereinstimmt.An abutment 14 for ball pliers 15 is formed on the speculum 5. The ball tong 15 has two articulated arms 16 and 17, at the front ends of which inward bends 18 and 19 are provided. With the bends 18 and 19, the portio 2 can be gripped in order to bring the uterus 1 into a largely extended position by pulling on the spherical forceps 15. In this position, the ball tongs 15 are suspended with the aid of a bolt 20 in a slot 21 of the abutment 14. A catheter 22 with a catheter guide tube 23 is used for the actual transvaginal gamete transfer and for tube catheterization. The catheter guide tube 23 has a pre-shaped curvature 24 in its distal end region. The catheter guide tube 23 is spherical at its distal end. The ball 25 facilitates the easy insertion of the catheter guide tube into the entrance area of the tube 4. It goes without saying that the catheter guide tube 23 is hollow and allows the catheter 22 to be pushed through. In particular in its distal end region, but also extended to half its total length, the catheter guide tube 23 is designed to be very flexible and consists of a wound band construction that enables this extensive flexibility. At its proximal end, the catheter guide tube has an insertion cone 26 for the catheter 22. A radially offset wing 27 is also provided in the proximal end region and is arranged in such a way that it coincides with the curvature 24 in the distal end region of the catheter guide tube 23.

An der Kugelzange 15 ist eine Klemmhalterung 28 vorgesehen, die in das Katheterführungsrohr 23 eingeklemmt werden kann. Auf diese Weise kann der Sitz des Katheterführungsrohrs 23 nach dem Einführen fixiert werden. Das Katheterführungsrohr 23 hat seinen ordnungsgemäßen Sitz dann erreicht, wenn sich die Kugel 25 am Eingang der Tube 4 befindet. Letztlich ist das Katheterführungsrohr 23 über die Kugelzange 15 an dem Spekulum 5 gelagert. Außen auf dem Katheterführungsrohr 23 ist eine Skala 29 angebracht, die mit der Klemmhalterung 28 zusammenarbeitet und der Orientierung dient.A clamping bracket 28 is provided on the spherical forceps 15 and can be clamped into the catheter guide tube 23. In this way, the seat of the catheter guide tube 23 can be fixed after insertion. The catheter guide tube 23 has reached its proper seat when the ball 25 is at the entrance to the tube 4. Ultimately, the catheter guide tube 23 is mounted on the speculum 5 via the ball forceps 15. On the outside of the catheter guide tube 23 there is a scale 29 which cooperates with the clamping bracket 28 and serves for orientation.

Der Katheter 22 besteht im wesentlichen aus einem dünnen Kunststoffrohr 30 und ist sehr flexibel ausgebildet. Auf der Außenseite des Kunststoffrohrs 30 ist eine Skala 31, die mit dem proximalen Ende des Katheterführungsrohrs 23, also dem Einführkonus 26, zusammenarbeitet, vorgesehen. Das Kunststoffrohr 30 besitzt einen distalen Endteil 32, welcher gegenüber dem übrigen Teil des Kunststoffrohrs 30 einen reduzierten Durchmesser aufweist. Es handelt sich dabei um den Teil des Katheters 22, der über das distale Ende des Katheterführungsrohrs 23 hinausgeschoben wird, um durch den isthmischen Tubenabschnitt zu gelangen. Das distale Ende 33 des Katheters 22 ist abgerundet ausgebildet. Am proximalen Ende des Katheters 22 ist ein Anschluß 34 für eine Spritze vorgesehen.The catheter 22 essentially consists of a thin plastic tube 30 and is very flexible. On the outside of the plastic tube 30 there is a scale 31 which cooperates with the proximal end of the catheter guide tube 23, that is to say the insertion cone 26. The plastic tube 30 has a distal end part 32, which has a reduced diameter compared to the remaining part of the plastic tube 30. It is the part of the catheter 22 which is pushed over the distal end of the catheter guide tube 23 in order to pass through the isthmic tube section. The distal end 33 of the catheter 22 is rounded. A connector 34 for a syringe is provided at the proximal end of the catheter 22.

Die Benutzung des Instrumentensatzes aus Katheter 22 und Katheterführungsrohr 23 geschieht wie folgt:
Zunächst wird das Katheterführungsrohr 23 über das Endometrium 3 bis zum Eingang der Tube 4 eingeführt. Das Katheterführungsrohr 23 kann beim Einführen feinfühlig geschoben werden. Durch Drehen des Katheterführungsrohrs 23 kann die Krümmung 24 so verlagert werden, daß das Einführen gegen einen möglichst geringen Widerstand und ohne jegliche Verletzungen geschieht. Der Flügel 27 zeigt dem Arzt an, nach welcher Seite die Krümmung 24 gerichtet ist. Hat das Katheterführungsrohr 23 seinen ordnungsgemäßen Sitz erreicht, so wird es in die Klemmhalterung 38 eingeklemmt, wobei sich der Arzt anhand der Skala 40 die ordnungsgemäße Lage und damit die Einführtiefe des Katheterführungsrohr 23 merken kann. Dies ist für einen Zweit- oder Mehrfacheinsatz des Instrumentensatzes bei der gleichen Patientin sinnvoll. Nachdem der Sitz des Katheterführungsrohrs 23 fixiert ist, wird der Katheter 22 mit seinem distalen Ende 44 in den Einführkonus 26 des Katheterführungsrohrs 23 eingeführt und zunächst soweit durchgeschoben, bis sich das distale Ende 33 des Katheters 22 an der Kugel 25 befindet. Dies wird dem Arzt durch den Beginn der Skala 31 angezeigt, deren erster Strich sich dann an dem Einführkonus 26 befindet. Jeder weitere Strich der Skala 31 zeigt dem Arzt dann an, daß das distale Ende 33 bzw. der Endteil 32 beispielsweise um einen weiteren Zentimeter aus dem Katheterführungsrohr 23 ausgetreten ist und die Kugel 25 überragt. Dabei wird auch hier der Katheter 22 feinfühlig verschoben, bis der Endteil 32 den isthmischen Tubenabschnitt durchsetzt. Nun kann sich der Arzt anhand der Skala 31 diese Lage, die spezifisch für die betreffende Patientin ist, merken oder notieren. Anschließend kann der transvaginale Gametentransfer erfolgen.The instrument set consisting of catheter 22 and catheter guide tube 23 is used as follows:
First, the catheter guide tube 23 is inserted through the endometrium 3 to the entrance of the tube 4. The catheter guide tube 23 can be pushed delicately during insertion. By rotating the catheter guide tube 23, the curvature 24 can so be relocated so that the insertion takes place against the lowest possible resistance and without any injuries. The wing 27 shows the doctor to which side the curvature 24 is directed. Once the catheter guide tube 23 has reached its proper seat, it is clamped into the clamp holder 38, and the doctor can use the scale 40 to remember the correct position and thus the insertion depth of the catheter guide tube 23. This is useful for a second or multiple use of the instrument set with the same patient. After the seat of the catheter guide tube 23 is fixed, the distal end 44 of the catheter 22 is inserted into the insertion cone 26 of the catheter guide tube 23 and first pushed through until the distal end 33 of the catheter 22 is on the ball 25. This is indicated to the doctor by the start of the scale 31, the first line of which is then on the insertion cone 26. Each further line on the scale 31 then indicates to the doctor that the distal end 33 or the end part 32 has exited the catheter guide tube 23, for example by a further centimeter, and projects beyond the ball 25. Here, too, the catheter 22 is shifted gently until the end part 32 passes through the isthmic tube section. The doctor can now use the scale 31 to note or note this position, which is specific to the patient concerned. The transvaginal gamete transfer can then take place.

Bezugszeichenliste:Reference symbol list:

11
= Uterus= Uterus
22nd
= Portio= Portio
33rd
= Endometrium= Endometrium
44th
= Tube= Tube
55
= Spekulum= Speculum
66
= Scheide= Vagina
77
= Oberlöffel= Top spoon
88th
= Unterlöffel= Lower spoon
99
= Gelenk= Joint
1010th
= Spreizeinrichtung= Spreading device
1111
= Mutter= Mother
1212th
= Aussparung= Recess
1313
= Ausnehmung= Recess
1414
= Widerlager= Abutment
1515
= Kugelzange= Ball nose pliers
1616
= Gelenkarm= Articulated arm
1717th
= Gelenkarm= Articulated arm
1818th
= Umbiegung= Bend
1919th
= Umbiegung= Bend
2020th
= Bolzen= Bolt
2121
= Schlitz= Slot
2222
= Katheter= Catheter
2323
= Katheterführungsrohr= Catheter guide tube
2424th
= Krümmung= Curvature
2525th
= Kugel= Ball
2626
= Einführkonus= Insertion cone
2727
= Flügel= Wing
2828
= Klemmhalterung= Clamp bracket
2929
= Skala= Scale
3030th
= Kunststoffrohr= Plastic pipe
3131
= Skala= Scale
3232
= Endteil= End part
3333
= Ende= End
3434
= Anschluß= Connection

Claims (5)

  1. Set of instruments for the transvaginal gamete transfer and for tube catheteration comprising a catheter guide tube and a catheter, wherein the catheter guide tube comprises in its distal end region a curvature with regard to its axis and is bulged at its distal end, characterized in that the bulge of the distal end is formed ball-like and that the catheter guide tube is flexible in its distal end region and is comprised by a spirally rolled ribbon construction.
  2. Set of instruments according to claim 1, characterized in that the catheter guide tube (23) in its proximal end region comprises a radially offset wing (27) which is corresponding to the curvature (26) disposed on the circumference of the catheter guide tube (23).
  3. Set of instruments according to one of the preceding claims 1 and 2, characterized in that the catheter guide tube (23) comprises on its outside a scale (29) for orientation purposes.
  4. Set of instruments according to one of the preceding claims 1 to 3, characterized in that the catheter (22) comprises on its outside a scale (31) cooperating with the proximal end of the catheter guide tube (23).
  5. Set of instruments according to one of the preceding claims 1 to 4, characterized in that the distal end portion of the catheter is reduced in diameter.
EP91118952A 1989-12-04 1990-11-13 Set of instruments for the transvaginal gamete transfer and for catheterization Expired - Lifetime EP0481527B1 (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
DE3940064 1989-12-04
DE3940064A DE3940064A1 (en) 1989-12-04 1989-12-04 INSTRUMENT SET FOR INTERVENTIONS ON THE UTERUS
EP90121663A EP0436091B1 (en) 1989-12-04 1990-11-13 Set of instruments for operations on the uterus

Related Parent Applications (1)

Application Number Title Priority Date Filing Date
EP90121663.0 Division 1990-11-13

Publications (2)

Publication Number Publication Date
EP0481527A1 EP0481527A1 (en) 1992-04-22
EP0481527B1 true EP0481527B1 (en) 1995-05-03

Family

ID=6394778

Family Applications (2)

Application Number Title Priority Date Filing Date
EP90121663A Expired - Lifetime EP0436091B1 (en) 1989-12-04 1990-11-13 Set of instruments for operations on the uterus
EP91118952A Expired - Lifetime EP0481527B1 (en) 1989-12-04 1990-11-13 Set of instruments for the transvaginal gamete transfer and for catheterization

Family Applications Before (1)

Application Number Title Priority Date Filing Date
EP90121663A Expired - Lifetime EP0436091B1 (en) 1989-12-04 1990-11-13 Set of instruments for operations on the uterus

Country Status (4)

Country Link
US (1) US5167222A (en)
EP (2) EP0436091B1 (en)
AU (1) AU636927B2 (en)
DE (4) DE3940064A1 (en)

Families Citing this family (17)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE4415074C1 (en) * 1994-04-29 1995-08-17 Aesculap Ag Surgical retractor for use with heart surgery
NL1013958C2 (en) * 1999-12-24 2001-06-26 Bernhard Wilhelm Geziena Nicol Vagina speculum.
US7048744B2 (en) * 2001-04-26 2006-05-23 Sol Wiess Attachable surgical accessory instrument
US6302842B1 (en) 2001-01-11 2001-10-16 Innovative Surgical Design Llc Episiotomy retractor
DE10208508B4 (en) * 2001-06-29 2006-12-07 Georg-August-Universität Göttingen Atraumatic uterine operation set
GB0218752D0 (en) * 2002-08-13 2002-09-18 Smiths Group Plc Vaginal specula
US20040097961A1 (en) * 2002-11-19 2004-05-20 Vascular Control System Tenaculum for use with occlusion devices
US20080312508A1 (en) * 2003-12-15 2008-12-18 Adrian Shulman Vaginal Speculum Assembly
US20100305406A1 (en) * 2009-05-26 2010-12-02 Ori Braun System, device and method for gynecological use
US20110046448A1 (en) * 2009-08-03 2011-02-24 Anthony Paolitto Cardiac tissue retractor with associated valve cusp depressor
US8696561B2 (en) 2010-04-01 2014-04-15 Tamatha Britt Fenster LEEP safety guard
CN102138821A (en) * 2011-04-07 2011-08-03 佛山特种医用导管有限责任公司 Oviduct connecting device
US20140257098A1 (en) * 2013-03-05 2014-09-11 Giuseppe Del Priore Systems and methods for detection of cancer in women
US20140358157A1 (en) * 2013-06-03 2014-12-04 Nathan Guerette Apparatuses and systems for knotless abdominal sacral colpopexy
WO2017173232A1 (en) * 2016-04-01 2017-10-05 Langell John Thomas Uterine contraction device
CN110584586B (en) * 2019-09-29 2021-10-19 温州市中心医院 Vaginal speculum
MX2020006458A (en) 2020-06-18 2022-05-30 Villa Juan Gerardo Barroso Cannula stabilizer for embryonic transfer.

Family Cites Families (19)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR820253A (en) * 1936-05-19 1937-11-08 Felten & Guilleaume Carlswerk Sleeve for high frequency lines
FR820618A (en) * 1937-04-14 1937-11-16 Device intended for the exploration of the female genital tract and for various gynecological procedures
US2545201A (en) * 1949-09-23 1951-03-13 Taylor C Gilbert Vaginal speculum
US2844144A (en) * 1955-08-12 1958-07-22 Massey John Bruce Surgical apparatus
US2858826A (en) * 1957-01-22 1958-11-04 Kahn Edward Vaginal speculum
US3320948A (en) * 1964-06-24 1967-05-23 Dept Of Obstetrics And Gynecol Positioning instrument clamp for use with speculum
US3789829A (en) * 1971-06-01 1974-02-05 H Hasson Vaginal radium applicator
US3750646A (en) * 1971-12-16 1973-08-07 C Patterson Transport system for bacteria with provisions for carbogenophilic organisms
US3847143A (en) * 1973-05-01 1974-11-12 Medspecs Inc Speculum
US4000743A (en) * 1975-07-09 1977-01-04 Kenneth Weaver Uterine anteverter
US4068659A (en) * 1976-07-12 1978-01-17 Deseret Pharmaceutical Co., Inc. Catheter placement assembly
DE2727273A1 (en) * 1977-06-16 1979-01-04 Neumo Gmbh Flexible sheath for electro-resectoscope - is of specified size and wall thickness to protect spherical ended operating member inside
US4323057A (en) * 1980-05-27 1982-04-06 Jamieson David J Self retaining uterine elevator
US4350151A (en) * 1981-03-12 1982-09-21 Lone Star Medical Products, Inc. Expanding dilator
US4432352A (en) * 1982-03-08 1984-02-21 Wineland Richard D Cervical traction kit
FR2556596B1 (en) * 1983-12-16 1986-12-05 Cassou Robert INSTRUMENTS FOR GYNECOLOGICAL ACTION, ESPECIALLY TRANSFER OF EMBRYOS
US4634432A (en) * 1985-05-13 1987-01-06 Nuri Kocak Introducer sheath assembly
DD274130A3 (en) * 1987-11-02 1989-12-13 Kreiskrankenhaus Grimma GUIDE PART FOR DUTIES
FR2635453A1 (en) * 1988-08-17 1990-02-23 Ingenor Laboratoire Device for catheterisation of the Fallopian tubes from underneath

Also Published As

Publication number Publication date
DE59009028D1 (en) 1995-06-08
DE3940064A1 (en) 1991-06-06
US5167222A (en) 1992-12-01
DE59008357D1 (en) 1995-03-09
AU636927B2 (en) 1993-05-13
EP0481527A1 (en) 1992-04-22
EP0436091B1 (en) 1995-01-25
AU6669790A (en) 1991-06-06
EP0436091A1 (en) 1991-07-10
DE3943616C2 (en) 1994-05-11
DE3940064C2 (en) 1992-02-06

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